Department of City and Regional Planning, Cornell University, Ithaca, NY 14853, USA.
Department of Human Development, Roybal Center, Cornell University, Ithaca, NY 14853, USA.
Int J Environ Res Public Health. 2020 Feb 17;17(4):1275. doi: 10.3390/ijerph17041275.
In the US, rural communities face challenges to meet the community health needs of older adults and children. Meanwhile, rural areas lag in age-friendly built environment and services. AARP, a US based organization promoting livability for all ages, has developed a Livability Index based on the World Health Organization's (WHO) domains of age-friendly communities: health, housing, neighborhood, transportation, environment, engagement, and opportunity. This study links the 2018 AARP Livability Index categories with demographic structure and socio-economic factors from the American Community Survey at the county level in the US to examine if the physical, built and social environment differentiate communities with better community health across the rural-urban divide. Results show that the neighborhood built environment has the largest impact on community health for all county types. Although rural areas lag in community health, those which give more attention to engagement and opportunity rank higher. Rural communities with more African Americans, children, and poor Whites, rank lower on community health. While neighborhood characteristics have the strongest link to community health, a broader approach with attention to age, race, poverty and engagement and opportunity is needed for rural areas.
在美国，农村社区面临着满足老年人和儿童社区健康需求的挑战。与此同时，农村地区在适合老年人居住的建筑环境和服务方面落后。总部设在美国的促进所有年龄段宜居性的组织 AARP 根据世界卫生组织（WHO）的友好社区领域制定了宜居指数：健康、住房、邻里、交通、环境、参与和机会。本研究将 2018 年 AARP 宜居指数类别与美国县一级的美国社区调查中的人口结构和社会经济因素联系起来，以检验物理、建筑和社会环境是否可以区分城乡差距中社区健康状况更好的社区。结果表明，邻里建筑环境对所有县类型的社区健康都有最大的影响。尽管农村地区的社区健康状况较差，但那些更加关注参与和机会的地区排名更高。拥有更多非裔美国人、儿童和贫困白人的农村社区在社区健康方面的排名较低。虽然邻里特征与社区健康有最强的联系，但农村地区需要更广泛的方法，关注年龄、种族、贫困以及参与和机会。
